Effects of HbA(1c) and weight reduction on blood pressure in patients with type 2 diabetes mellitus treated with exenatide.

MedLine Citation:

PMID:
22510305
Owner:
NLM
Status:
Publisher

Abstract/OtherAbstract:

Aim: Treatment of patients with type 2 diabetes with GLP-1 receptor agonist exenatide has demonstrated improvements in glycemic control coupled with weight loss and lowered blood pressure. We examined the synergy between improved glycemia and weight loss on blood pressure reduction in patients treated with either exenatide twice daily (BID) or once weekly (QW). Methods: Combining data from 3 controlled trials, 686 (53% male) patients (baseline mean±SD: age 55±10 years, weight 95±20 kg, SBP/DBP 130/79 ±15/9 mmHg, HbA(1c) 8.3±1.1%) treated with exenatide QW (n=541) or BID (n=145) were observed over 26 weeks. Using weighted means (WM) of the longitudinal measures of HbA(1c) and weight, patients were subdivided into 4 groups at each visit by glycemic and weight responses; patients who failed to reduce both HbA(1c) and weight below WMs became the reference group (R). The other 3 groups corresponded to patients with HbA(1c) reduction (A), weight reduction (W), and both HbA(1c) and weight reduction (AW). Results: Compared to R, patients in AW, A, and W groups had a significantly higher likelihood of improving SBP <130 mmHg by 88%, 30% and 61% respectively. Compared to R, patients in AW, A, and W had 63%, 13% and 45% higher likelihood of improving DBP <80 mmHg. Conclusion: Although the mechanism of blood pressure lowering effect of exenatide is not established, it appears that the short-term dynamics of blood pressure is related to concomitant effects on glycemia and body weight. These data offer a preliminary insight into the possible cardiometabolic effects of GLP-1 receptor agonism.